You know, there's also just a such a huge mental health component.

So we're talking about 40 years ago.

Knowledge is power.

So when a woman is going into her doctor and she's talking to her GP or her gynecologist and is, you know, in the throes of menopause and.

Perimenopause, yet they have natural hormones back at the right dose and type, and they are transformed.

You know, we're putting people in these chemical straight jackets, giving them highly toxic drugs without thinking about safe hormones.

With perimenopause and menopause, so many women, and I know, I feel included too.

You know, do we just feel like we've lost ourselves?

We're like, who are we?

You know, what is this?

If I had a rash on my face, you would look at me and go, oh, Louise, that looks painful.

Have you seen a dermatologist?

Whereas if I tell you I feel so joyless and flat and low, you might go, oh, it's a bit awkward now.

I don't quite know what to say, you know.

Okay, ladies, this is not your mom's menopause.

Today we're diving into the real, raw and revolutionary truth about hormones, perimenopause, and what the heck is actually happening to our bodies in midlife.

With one of the world's leading voices on women's health.

My guest today is Dr.

Louise Newson, a world renowned menopause specialist, best selling author and founder of the Newson Health Menopause and Center.

She's the force behind some of the most important research and policy changes in women's health care.

And her work has empowered millions of women to reclaim their health, their hormones and their confidence.

So if you've ever been told it's just anxiety, or if you've ever left a doctor's office feeling more confused than when you walked in, or.

Or if you've ever looked in the mirror and wondered who that tired, brain foggy, bloated woman is staring back at you.

This conversation is for you.

Get ready to feel informed, fired up and seen.

Let's get into it.

Welcome, Dr.

Newson.

It's wonderful to have you here today.

Oh, well, thank you for inviting me.

It's a real honor to be here.

Oh, I'm just so excited.

I appreciate you.

For those who don't know, Dr.

Louise Newson is in London.

So we are excited to have you on and I just want to dive right in because I think that there are so many misconceptions and so many, you know, things that we've heard about menopause, perimenopause, the hormones, everything.

And women are really not informed about their bodies.

So, you know, and so many of us, when we go to the doctor, we're either misdiagnosed or we're dismissed by our doctors, especially during perimenopause.

So, so what do you.

Why do you think that the medical system is failing women in this way?

You're right, though, it's due a lot to misunderstanding.

And it's not just misunderstanding by women, but healthcare professionals as well.

And the problem is, and even now, if you ask someone what menopause means, they'll tell you it's hot flashes.

It's a natural transition that women go through, which absolutely it is.

And it isn't because it's far more than hot flashes.

It may be natural, but it doesn't mean we can't treat it.

And it's not a transition.

It's not something we will just phase in our lives.

So women have been told wrong information, but so have doctors.

You know, I qualified quite a few years ago in 1994, but I didn't have any formal menopause training.

And then for many years, in fact decades, people, doctors have been told HRT is dangerous, don't prescribe it for women.

So then they not been learning about menopause because they think there's no treatment which is so wrong on so many levels, which we can talk about.

So this misunderstanding has carried on.

And then when people are confused, they often go to the wrong sources or they get the wrong information or they speak to the wrong people and then it causes more confusion.

So it's absolute mess.

And this is a travesty for women because within, amongst all this mess and confusion, women are suffering and they're having health risks as well from not having their hormone health addressed properly.

And you know, that is.

So the hot button topic right now are HTRTs.

I mean, there's so much confusion going around about hormone replacement therapy.

Should I do it, should I not do it?

What are my risks?

Like, am I going to be at a higher risk for breast cancer?

You know, that's a lot of concern on women's minds.

So can we kind of break that down and kind of dispel some of the untruths that are associated with hrts?

And is it for everybody?

Yeah.

So I think before I talk about hrt, it's worth talking about menopause and hormones because what happens when we don't have those hormones?

It can affect our body in so many ways.

But when we talk about hormones, we're only talking about three hormones.

We've got hundreds of hormones in our body, and they are chemical messengers that go into our blood and affect every.

Every single cellular process.

So every cell responds to hormones, so they are biologically active, natural substances.

So when we talk about estrogen, we talk about estradiol, which is the most important form of estrogen, progesterone, and testosterone as well, which is an important female hormone.

So when we give hormone replacement therapy, all we're thinking about is those three hormones.

And there are different doses, there are different types of.

All we're doing is replacing the hormones.

And we do this for two reasons, really.

The first is to improve symptoms.

Because there are a myriad of symptoms that women who are menopausal, perimenopausal can experience, mainly affecting our brains, actually.

The brain fog, the low mood, the anxiety, the poor sleep, the irritability, the feeling quite joyless and flat.

So we can improve the way people feel with hormones, which actually is not a bad thing if women feel better.

But more importantly for me as a physician, it's about improving our future health.

Because these hormones work on every cell.

So therefore, in every organ of our body.

They help reduce inflammation, they help keep our organs.

So our heart, our bones, our brains work better.

So we know that when people have replacement hormones at the right dose and type for.

For them, their future health improves.

They have a lower risk of heart disease, a lower risk of osteoporosis, a lower risk of type 2 diabetes, Parkinson's, dementia, other conditions as well.

And that's really important that we think about it beyond just a treatment for a few hot flushes.

So I'm glad you're kind of laying it all out, because I think people think hormone replacement therapy, and they think it's an all for one and a one for all.

And there's one treatment, and.

But really there's varying levels of these different hormones.

And depending on what the needs are for your body and for your stage, that's like.

That would be the hormone.

It's very individualized.

It's completely individualized.

And it's also really important.

You know, when I talk about giving hormones to women who are perimenopausal and menopausal, these are a natural.

They're natural in that they are a complete replica of the hormones we have when we're younger, when I talk about prescribing hormones as part of contraception, these are all synthetic, They've been chemically altered.

Yet no one, across the world seems to worry about contraception, which by the way has more risks because it's not a natural replica.

But these are natural hormones.

We have had synthetic hormones in the past.

And in fact, the HRT that everyone is concerned about from the whi, the Women's Health Initiative study was made from pregnant horses urine.

Like, we don't use that.

You could argue that pregnant horses urine is natural, but it's not natural for women to have.

So, you know, HRT has moved on, but when we talk about it, we have to be very clear and particular whether it's a natural or synthetic hormone.

And like you say the type and the dose because if you're not on the right dose, if you're not on the right type, so say you're testosterone deficient and you're only having estradiol, you can have all the estrogen you like, but it's not going to help those testosterone depleted cells.

So that's where it's really crucially important that everybody is seen as an individual and the dose and type is individualized for them.

Now, as far as the health risks go, who are the women that should not be taking hrt?

Are they the women that have already had breast cancer or that are at risk for breast cancer and other female cancers due to family history?

So as a, as a doctor, my role really is to help women make the right decisions for them and to share any uncertainty, to talk about shared decision making.

So there is no one who absolutely can't have anything.

You know, that's the most important thing is that there's never been a study to show that people are going to literally die overnight by having their own hormones back.

So then we look at the evidence, but sometimes there's lack of evidence.

So if we answer the easy things first, lots of people are told they can't have HRT because they've had a history of a clot, for example, or they have migraine or there's someone in their family has got a history of clot.

Now older types of hormones and tablet oestrogen do contain a small risk of clot associated with them.

But the natural hormones, the estrogen through the skin, the estradiol, the natural progesterone, natural testosterone and do not have a risk of clot.

And then people worry about the cancer risk.

Now the breast cancer risk has been associated with the synthetic progestogens that are in contraception.

But even then the WHI study didn't show it was statistically significant.

But they are the only studies that show there was a risk with breast cancer.

So when we give the natural hormones, it's unlikely to be increasing our risk of cancer, because younger people are less at risk of cancer than older people who don't have hormones naturally, of course.

So people who have a family history of breast cancer or they've had a history of most types of cancer, they can still usually safely have hormones.

The big uncertainty is women who've had breast cancer.

But there are different types, there are different grades of breast cancer, and there are different times.

Since people have had breast cancer cancer, we look at the receptor status of breast cancer.

So is it oestrogen receptor positive or negative?

And firstly, it's worth explaining that an estrogen receptor positive breast cancer does not mean it's been caused by oestrogen.

It means it's got oestrogen receptors on it.

We have estrogen receptors on every cell in our body.

If a cancer becomes mutated, then there's going to lose some of its receptor status and become estrogen receptor negative.

But we don't know whether giving oestrogen to women with estrogen positive breast cancers or oestrogen receptor positive breast cancers increases their risk of a recurrence or a worse outcome going forwards.

Some studies have shown that women do better after having hrt, but the studies haven't been set up in the right way for the right length of time.

So then we're dealing with uncertainty now.

There are different types of hormones, like I've said.

Some studies have shown that women who have testosterone after breast cancer have a better outcome, a less instance of recurrence, and less incidence of problems going forwards with their breast cancer.

We also know that women who take hrt, whether they've had breast cancer or not, as I've said, have a lower risk of osteoporosis and heart disease and feel better.

So we see people in our clinic who have had breast cancer.

Some of them might have been 10, 20 years ago.

They've been told they can never have hormones, yet they've got osteoporosis, they've given up their job, they're feeling so awful, They've tried every supplement under the sun, they've been on antidepressants, they've been on alternatives.

And they say, do you know what, Dr.

Newson?

It might increase my risk, but I know what it's like to have had breast cancer and I'll forego that risk.

It means my bones will be stronger if it means that I'll be a happier person, if it means I can reduce some of these antidepressants and that's what I said at the beginning.

It's an individualized choice, really.

I feel really sad when people are just told, no, you can never have HRT because there's no evidence that it's absolutely harmful.

And even if we did have that evidence, we still know it's beneficially as well.

And that's where it comes to a very individualized consultations.

In the case that a woman, let's say she is not able to take an HRT due to, you know, hormone receptive breast cancer, is there a natural supplement that would alleviate some of the symptoms or help through menopause?

So we need to think about when we talk about a natural supplement, because hormones are natural.

Of course, there are lots of things that are marketed as natural, but they can be risky.

You know, there's lots of things that grow in my garden that are natural, but they could be poisonous if I ingest them.

So we have to be careful what we take.

When we think about supplements for menopause, a lot of them are marketed to vulnerable women.

And so we have to think about, firstly, are they going to help symptoms and secondly, are they going to help future health?

Some might improve symptoms, so things like sage might improve some hot flushes and sweats.

Some of the other drugs that sometimes are prescribed non hormonal drugs might help flushes and sweats, but they very seldom.

There's no evidence often that they're going to improve the brain fog, the fatigue, the muscle and joint pains, the urinary tract infections, for example.

But also it's looking at future health.

So if someone doesn't want to take hormones for whatever reason, then we need to look at how am I going to reduce that person's risk of heart disease, increase their bone strength.

So I might be thinking about vitamin D supplement, I might be thinking about magnesium, or I might be thinking about a probiotic for their future health rather than for their menopause.

Because we need to be thinking about menopause as something that lasts with us forever.

So it's not just a transition because once the hormones are low, they're low forever.

So whether we have symptoms or not, we still have this risk of diseases.

And so some of people are thinking, oh, I just have a quick fix to help a few symptoms that might last for a short period of time.

Well, no, let's think about how we improve our future health in the longer term.

And working with patients, whether they take hormones or not, we need to be thinking very holistically about keeping healthy and preventing Diseases.

I'm so glad you brought that up.

That it isn't just a transition, it is actually a life stage that extends far past that.

Indeed.

Right.

And it's something that I think as women, we really need to, you know, grasp and like, really understand that you're really planning for your future health.

And it's so important because we've been fed all this misinformation, because when you read studies, they'll say, oh, symptoms might only in inverted commas last seven to ten years.

So then a lot of women think, all right, so if I, my last period is when I'm 50, I'll be done by I'm 60 and then I'm through the menopause.

And I, I was recently in New York and I went out to dinner with some gorgeous ladies and they go, oh, no, I'm through the menopause.

It's like, you're not, you're still alive.

How can you be through it?

You are always going to be menopausal.

And then they were like, oh, my goodness.

What you mean I've always got low hormones?

It's like, yep.

So it's a different mindset, but we have to be waking up to it because we're living longer as women, which is great.

But we all want to be healthy, don't we?

So we've got to be thinking about how these lack of hormones have effects on our bodies.

Absolutely.

And let's talk a little bit about testosterone because that is such a hot button topic.

You know, I think for a lot of women, they think the word testosterone and they're thinking about their partners or their husbands, you know, like, you know, men, this is like a male hormone, but it in fact is not.

Women have quite a bit of testosterone.

Yeah.

And it's such a shame, isn't it, that they called it testosterone from the bull's testes, which is where they first extracted it from.

Oh, wow.

It's real shame.

If they called it anything else, we wouldn't be having this debate.

But what's really interesting is that it's the most biologically active hormone women have.

We have more testosterone than estrogen in our bodies when we're young, when we're in our late teens, early 20s, and then levels start to decline with age.

So from the late 20s, early 30s, our levels decline naturally.

So it's not really a menopause related decline, it's an age related decline.

But about 50% of our testosterone is made in our ovaries.

So those women that have a surgical menopause so they have their ovaries removed at a young age, will reduce and lower their testosterone quicker than other people.

But testosterone works on every cell in our body.

It's made in our brain as well, and it's a very important hormone for the way our brains work.

So people symptoms of testosterone deficiency are often low mood, reduced energy, poor sleep, brain fog, poor concentration, but also headaches, migraines, muscle and joint pains, urinary symptoms, because we have testosterone receptors in our bladder as well.

Myriad of symptoms.

But the only studies really that have been done on testosterone in women have been looking at our libido and our sexual function.

So then a lot of menopause societies and some specialists will say, well, we can only give it to women who have hypoactive sexual desire disorder, which basically means they have really awful libido that's giving them severe psychological distress for at least six months.

Which in my mind feels completely barbaric because in medicine we don't watch people suffer for at least six months, we intervene a bit earlier.

And testosterone isn't just about sexual.

Of course it can help people's libido, it can help people with orgasm and sexual desire.

But as women, it's not just a hormone related thing whether we want sex or not.

Absolutely.

And I'm glad you're bringing that up also because I think sex is a really tough issue at this stage in our lives.

You know, it's not only with the loss of hormones that you lose sometimes the desire to have sex, but it can actually be painful.

Absolutely.

And this is really important.

And you know, studies even now show that women are very nervous about talking about sex to their healthcare professional.

And what's really sad is a lot of healthcare professionals don't want to bring up sex in the consultation.

Yeah.

Actually the more I talk about it to patients, the more they say, I'm so pleased we're talking about it because I don't know who else to talk about.

And symptoms of vaginal dryness, soreness, irritation are the most commonest symptoms that persist in menopause.

We know about 70% of menopausal women have symptoms, symptoms related to vaginal dryness, soreness.

Yet only about 10% of women receive treatment.

And HRT can improve symptoms.

But more importantly, vaginal hormones can.

Vaginal hormones are very low dose given in the vagina, but they can also help urinary symptoms as well.

And they can be safely used, usually for women who've had breast cancer too.

So even if women don't want to Take hrt, or they take decided that it's not for them, they should still consider vaginal hormones, which can be transformational for sex, but also just for reducing urinary tract infections and cystitis, which are so common in people, especially as they age.

Absolutely.

And also this phenomenon of vaginal atrophy, which I recently learned about.

I mean, the symptoms keep coming, don't they?

Well, do you know what they used to call it?

Vva.

So vulvovaginal atrophy.

Now, if you look up the word atrophy in a dictionary, it's actually withering and wasting away.

Like, which part of our anatomy really wants to be withering and wasting away?

Right.

So if they have changed the nomenclature, so it's gsm, genitourinary syndrome of menopause.

But it's not just menopause.

I see a lot of young women who are perimenopausal or women who are just testosterone deficient who have this genitourinary symptoms.

So we need to be really tuned about that as well.

Absolutely.

And is it possible for somebody, let's say they haven't started hrts yet, they're not doing hormone therapy, but they have gained the weight that sometimes comes with perimenopause and menopause.

Is there a way to lose the weight without taking an HRT or before you start taking an hrt?

Yes, it's a great question.

And, you know, probably every woman wants or thinks about their weight or wants to lose a bit of weight.

I mean, it's just.

I don't know, there's something about our genetic profile, probably.

But we know that our metabolism changes with our hormones, especially estradiol and testosterone.

They have direct effects in our brain, which helps our metabolism.

And our brain has very direct pathways with our liver, but also our pancreas and our glucose metabolism and insulin as well.

So there are so many people.

And I feel really embarrassed because for many years people would come to me as a GP, a family physician and say, oh, Dr.

Newson, I put on all this weight and my lifestyle hasn't changed.

And I'd look at them and go, really?

Surely you're sneaking in some extra whatever.

But actually, no, their metabolism is changing.

And also the way they respond, the way they have some insulin resistance, can it increase quite early on?

And often they think they're not perimenopausal or they think they might not have testosterone deficiency, but they probably have.

And we know that when people have replacement hormones, their sugar levels can improve and their metabolism can improve.

We know there's like a massive thing, isn't there, for all the GLP1s, which I don't actually prescribe, because I think it's a lot better if you can look at the underlying cause.

So a lot of people actually have maybe some PMS or premenstrual syndrome or pmdd, premenstrual dysphoric disorder.

So they might find it's those week or days before their periods, they have sugar cravings, they're eating more, they're having more comfort foods because they're feeling lower in their mood and that will change their metabolism because their estradiol is dropping before their periods.

So they might not be officially perimenopausal, but they will have hormonal changes.

So we need to be thinking about these hormonal changes and helping them replace them with natural hormones, which cannot often improve.

A lot of people are given synthetic hormones when they're younger, so contraception, because doctors will often say, well, this will smooth out your hormones.

Well, it won't.

It will block all your hormones working.

So a lot of people on contraception tend to put on weight or they find it harder to build muscle, harder to exercise.

So we need to be really, I think, thinking about hormones, thinking about lifestyle before we do anything else about weight.

So if somebody is taking the GLP1s and the Ozempic, is that going to have an effect on their menopause, their perimenopause?

Are the two.

Do they go hand in hand?

Probably not.

I mean, there's very little work.

When you look, there are some studies that show if people are on GLP1s and HRT, they'll have better weight loss.

One of the concerns, as I'm sure you know, is that when women, or some women who take GLP1s, they will lose fat, but they'll also lose lean muscle mass as well.

And so without our hormones, we have an increased risk of something called osteosarcopenia, which means loss of muscle and bone density too.

If we have loss of muscles, it often means we're less strong, we're more likely to fall.

If we have our bones are weaker, we're more likely to have osteoporosis.

So we don't want a drug that's going to make that worse for us as well.

So we have to be really careful.

There is a role, I'm sure, for GLP1s for some people, but so many women are taking them as a quick feature fix.

And I know, like doctors in the UK and probably with you as well, are just going, oh yeah, just try a low dose, just have these.

But they're not treating the underlying problem.

And in medicine you want to treat the underlying cause.

So it's balancing hormones, obviously, making sure people's thyroid is working well as well.

Because all our hormones work very closely together.

They don't work in isolation.

Absolutely.

And what are three actionable lifestyle changes that women could make today that would have a positive effect on their health 10 years from now?

So.

Well, the most important thing I think is to be really honest with yourself.

We all know what we should do, but sometimes it's hard.

I think adding something to your diet is really important.

So increasing the amount of fibre that we have and natural foods that we have, as in food that you could potentially grow in your garden, that you would recognize that hasn't been chemically altered.

So you want the real deal.

You want those fresh strawberries, not strawberry flavored goodness only knows what, because that makes a real difference.

I think also finding some exercise that you enjoy.

Like we can all do more exercise, but I look at my husband on his exercise bike and if I do more than 20 minutes, it will induce a migraine.

I'm very sensitive to migraines, so I circumvent it because I do a lot of yoga instead.

And he looks at me doing yoga and thinks, oh, that's not real exercise.

But you know what, I'm a lot more flexible than him and my pelvic floor is probably a lot better than his.

So.

But you've got to find something that you enjoy.

So doing exercise, looking at what you're eating and the other thing is really important to look at what you're drinking.

So I mean, I don't drink alcohol.

I don't expect everyone to be teetotal, but alcohol has a lot of calories.

But it also can affect our hormones and our metabolism.

But not just alcohol.

You know, go into any store and it's full of brightly colored drinks.

Like all these drinks are chemicals in our body.

Even if they're low sugar or whatever they're labeled, we should just be drinking water.

So do not be hoodwinked to think that these locale sugar free goodness.

Oh, what are not affecting our metabolism because they will be.

So looking at what you drink as well as eat and exercise are really important.

You know, there's also just such a huge mental health component with perimenopause and menopause and so many women.

And I know, I feel included too.

You know, do we just feel like we've lost ourselves.

We're like, who are we?

You know, what is this?

So what advice would you give to women who feel like they've lost themselves and are really struggling with their mental health during this time?

Most important thing is, is to recognize it and really think about hormones.

So I was reading a book recently.

It was a book I've read a few years ago, but it's about mental health and hormones and the brain.

And it was written in the 1980s, so we're talking about 40 years ago.

And it's showing the role of hormones in our brain, how it helps our brains to grow the cells, to grow the nerves, to grow the connections between the nerves to work well.

And also it helps other neurotransmitters.

So neurotransmitters and chemicals that send messages from one part of the brain to another.

And we know about neurotransmitters such as serotonin, our happy hormone, or dopamine, our reward hormone.

If we have low estradiol in our brain, it then has an effect where we have low serotonin and low dopamine so often reduces our mood.

We feel just joyless and flat because we don't have dopamine.

So we could do something that we'd normally enjoy and we're just like, oh, what's the point?

Point?

So if we know why it works, try and treat the underlying cause.

So having the right dose of Estrada will increase our serotonin, increase our dopamine, for example, increase the nerve pathways.

So many women are given antidepressants, and antidepressants will work if people are truly clinically depressed.

But they won't improve the low mood, the anxiety, the feeling of worthlessness and joyless if it's related to hormones.

So we need to be questioning ourselves as women if we think we're depressed and we're being offered hormone.

We've been offered antidepressants, but we feel there might be a hormonal component.

Sure, you can have the antidepressant, but think about hormones as well.

Think about hormones improving our mental health, because they often do.

And the hormones that really make a difference in, in my vast clinical experience in practices is actually the addition of testosterone.

You know, I see so many women who have been given not just antidepressants, but lithium, olanzapine, electroconvulsive therapy.

There's a vogue over here now that people have ketamine infusions for their so called treatment resistant depression, yet they have natural hormones back at the right dose and type, and they are transformed.

We're putting people in these chemical straitjackets, giving them highly toxic drugs without thinking about safe hormones.

So we need to be helping others as well.

Because sometimes when you have a mental health condition, you can't recognize it in yourself.

So you need your partner, your friend, your work colleague to go, louise, you're not quite the same.

You know, is there something else going on or could it be related to your hormones?

You know, I'm glad you're saying that too, because I opened up my DMs and asked the audience, you know, I said, are there questions that you have?

And you would be so shocked at how many husbands, boyfriends, partners, reached out to me and said, you know, my wife, my girlfriend, my friend is going through this and I don't know how to help her.

It's really hard.

It's so hard.

And, and you know what I mean?

This is funny, but it's not funny.

But my husband's a doctor and a few days ago I was, I thought I would just try a different formulation of testosterone because I've been on the same dose for a while and, and I thought, well, I'd just try this gel rather than the cream that I use.

And over the last three days, I've been sleeping in the day, I've been irritable, I've been tired, I've had joint pain, I've had a three day migraine.

And my husband just looked at me, went, ugh, are you perimenopausal again?

Because you're just the same as you were eight years ago.

And I went, oh, do you know what, Paul?

I've just changed my dose of hormones.

And he was like, oh my God, go back to what you were on before.

And.

But I knew that I'd changed, but he didn't know, but he recognized.

But eight years ago, we had six months of almost hell where I was shouting, it was awful, and he didn't recognize.

And I wish he had the knowledge he has now because if, you know, a few days, a few weeks, he would have then said, oh, Louise, perhaps, you know, you need to learn a bit more about hormones.

And it's really hard for partners because, you know, divorce rate increases in the 40s and, you know, I've spoken to so many partners, either male or female partners of women who just say, look, this isn't the person that I fell in love with.

But every time I talk to her, she's irritable, she's flat, she burst into tears, like, what have I done with social Tempered.

And it's not even.

A lot of them obviously, aren't having sex, but they're not having any physical contact.

You know, they just.

And it's really hard because that woman is often feeling so isolated and so scared, and so it's so hard to conceptualize.

And it's very different to clinical depression because a lot of women I see, even women who are really in the depths of despair don't want to be like this.

They'll do anything to feel better.

Whereas women who are clinically depressed don't have the same insight.

They'll just do whatever.

I don't.

Don't really care.

These women are petrified of how they're feeling, but they don't know who to talk to.

And.

And mental health, I think, is still really difficult.

Like, if I had a rash on my face, you would look at me and go, oh, Louise, that looks painful.

Have you seen a dermatologist?

Whereas if I tell you I feel so joyless and flat and low, you might go, oh, it's a bit awkward now.

I don't quite know.

You're what.

So, you know, but we need help.

And I.

And it.

But it's pointing people to hormones.

And, you know, people can still have psychiatric medication if they need it, but they can still have hormones as well.

And I'm really saddened that psychiatrists are not approaching hormones in a really embrace of inclusive way.

They're just going, oh, no, we don't prescribe hormones.

Let's prescribe some more other drugs instead.

It's still.

That's the crazy thing, too, that it's not treated holistically.

You know, the mind, the body and all coming together, and it, like, it would be so much more helpful.

Yeah, And I think it's getting worse because medicine's very siloed.

You know, you have palpitations and you see a cardiologist, you have urinary tract infections, you'll see a urologist, you have worsening migraines, headaches, you'll see a neurologist.

No one will think, well, what's joining the dots?

What.

What.

What are the hormones in this lady?

So.

So then people are given a heart drug for their palpitations, antibiotics for their urinary tract infections.

Often quite horrible drugs for migraines, you know, and so then people are getting side effects, they're getting other drugs.

So, you know, and it's awful.

Even if you think about pain, you know, people in menopause are far more likely to have chronic pain.

They're far more likely to prescribe opioids and tramadol, highly addictive drugs that doctors are dishing out like Smarties.

But you ask for some HRT and they'll be going, oh, oh, you sure you want that?

There's risks.

It's madness.

Oh my gosh, it's absolute madness.

So knowledge is power.

So when a woman is going into her doctor and she's talking to her GP or her gynecologist and is, you know, in the throes of menopause and perimenopause, what should she be telling them or what should she be asking them, you know, if she's feeling dismissed?

So the most important thing is having that knowledge before you go to a consultation.

So, you know, download Balance, the free app that I created.

Go to my website, drlowisenewson.co.uk, we've got lots of articles on there.

Find something that resonates with you, but make sure it's evidence based information that's not biased as well.

I don't do any paid work with pharma, just for complete disclosure.

Make sure that you're comfortable in your decision and then be really, you know, you might have to write things down.

It can be quite intimidating going to see a doctor, but then just say, look, I think or I know that I'm menopausal or perimenopausal, I would like to try some hormones and then think about, you know, if people are scared or they're not prescribing, then I think we should be asking as patients, why are you not prescribing me an evidence based treatment?

Why are you denying me a treatment that will reduce my risk of a heart attack and osteoporosis as well as help me feel better?

Because I think the only way we can change the conversation quickly is by women leading the consult, the consultations and conversations actually.

But you have to have the knowledge first.

But, you know, share your knowledge, go with someone else, go with a friend, go with a partner and make sure that you make the right decisions for you.

You know, we're all different, we're allowed to choose different things in life and we can choose about, you know, what we do with our hormonal health, also knowing that you can change your mind at any time.

So if you decide you want to stop your hormones or you don't want them now, but you might want them in a few years time, that's fine as well.

It's not a decision that you've, you know, drawn out in black and white and you can't change.

That's good to know.

And are there any supplements that we should all have in our medicine cabinet that are not only effective but, you know, would be something that would carry us through?

Yeah, So I would actually, as a rule of thumb, I would.

Anything that's labeled menopause, I would.

I just put in the bin because it's often marketing.

We should all be taking vitamin D.

Actually.

Vitamin D is really good for our bone health and reduces inflammation.

And then it's very individualized.

Actually.

Some women choose to take probiotic or fish oil, but I wouldn't take anything just because you're menopausal.

And the connection between menopause and heart health is something that I think a lot of women overlook and they also go hand in hand.

So keep up.

I would.

I mean, if you would agree to keep, you know, the heart check and really paying attention to that as well, because I think that's something that's very overlooked and that's the number one killer of women.

Yeah.

So heart disease and dementia, number one killers globally.

In women.

We're five times more likely to have a heart attack when we're menopausal if we don't have hormones.

Really important that we look at our blood pressure, you know, we make sure that our hearts are as healthy as possible as we age.

Definitely, definitely.

And what does thriving in midlife look to you?

Just being the best version of yourself.

I think the whole midlife is a.

Is a difficult word, isn't it?

Because when's the middle of our lives, like, who knows?

We haven't got a crystal ball.

But I think, you know, I'm quite a macabre person.

Sadly, my father died when I was very young and every day could be our last.

So we've got to make the most of it.

We can't be thinking, well, I'll do this in the future, or maybe I'll take up exercise in future, or maybe I'll change my diet, or maybe I'll change my job or whatever, or think about hormones in the future.

We've got to put ourselves first.

And I think one of the big things is just to be a bit selfish, actually put ourselves first, think about what we're going to do.

Because if we are the more healthy version of ourselves, we can then look after other people.

And that's really important.

Absolutely.

And what does living an iconic midlife look like to you?

Oh, I wish I knew.

If I knew, I could tell you.

I think being true to yourself and not comparing yourself with Others.

It's so easy as middle aged women to compare ourselves with others and think that we're not good enough, we haven't got this, we haven't done this.

But we've got to be comfortable in our own skin, otherwise we'll just, it can torment us.

And what is one midlife rule that you are breaking?

Oh, people have called me a disruptor, but I used to be quite good at, you know, I was never a naughty person at school, but I don't like, there's no boundaries.

I think what we can do now in, in this sort of modern world with social media, with media, I mean, look at us doing a podcast and we're not even in the same room.

Like we couldn't have done that before, before.

So I think disrupting is, is something that I'm doing but with other women, I'm carrying women with me and everything that I do and that makes it really enjoyable.

It is, it's such a wonderful feeling to know that there's a community behind you.

And what advice would you give your 25 year old self?

Oh, well, this is interesting because I've got three daughters, my oldest one's 22.

I would just be more kick ass.

I would be making sure, sure that I really knew as much as possible about my hormones.

So my oldest daughter takes hormones, she takes natural hormones and lots of her friends are taking synthetic contraception or they're feeling dreadful.

And she said to them the other day, do you know what, guys?

I feel the same every day of my cycle.

Like, I don't even know where my cycle is because I feel great every day.

And they were like, no, how, how does that happen?

And they're like, let me like take Tell me the secret Jess.

And she's like, well, just Google my mum and you'll find out about hormones.

So, you know, no one's too young to have this conversation.

And I think even as a young person, if you're helping your parent, your auntie, your teacher, someone you work with, or for you as you become older, or looking around and helping your friends, you know, Jessica's helped a lot of friends who have been on antidepressants, all sorts, and now they're on hormones.

So being really, you know, inquisitive, because that's how this conversation about hormones is changing, because women are asking the right questions.

And if somebody is starting natural hormones that young, does that substitute for contraception or is it just to keep hormones?

This is a whole other conversation because what's very interesting is that Hrt has never been tested as contraception.

But we have to remember when contraception was launched in the 60s, it was never tested as contraception.

It was only to help our periods.

But because the drug companies knew they'd make a lot of money, they changed the licensing without the evidence.

So, you know, but with a lot of people now, younger people will go for a coil, even a copper coil, for example, to use that as contraception.

And then if they have PMS or PMDD like my daughter has, they might use natural hormones just to top up their own hormones.

So they're still having hormones, but they're just having a low dose to just top up and regulate their own hormones in a natural way.

Because if they're given synthetic hormones, they'll block their natural hormones and often make them feel worse.

So it's a different way of thinking about hormones.

Oh, that's fascinating.

And I bet she feels so much better too.

Yes, she does.

She absolutely does.

And she has really bad migraines, so that really helps with migraines as well.

If you have a moment, I would love to go through just a few myths, if you could say true or false about these, because as you know online, there are many, many stories flying around.

Ok.

Okay.

So the first myth, Mythbuster.

True or false.

You can't be in perimenopause if you're on birth control.

Both.

Oh, okay.

You don't need to treat vaginal atrophy if you're not having sex.

That is a big false.

Okay.

Progesterone is only needed if you have a uterus.

That's a false.

Non menopausal women in their 30s should get a basic hormone blood panel to to get a baseline understanding of their hormone levels before perimenopause starts.

Oh, is that right?

You don't need the baseline.

What is baseline?

And it will change.

If you have eight blood tests in a day, you'll get eight different results.

So, wow.

Okay.

That's how much our hormones fluctuate.

Okay.

Once you're in menopause, your hormones stay low and steady.

They stay low, but not always steady because they can change because our muscles will produce some hormones.

Our heart produces hormones.

So they will fluctuate, but they will generally be low.

Oh, wow.

Okay.

Menopause does not affect your eyes.

No, that's false.

So it does.

I knew it.

I knew it.

My vision is just going more and more each day.

Okay.

So that is a direct result.

That's good to know.

You can't take HRT if you've Had a family member with breast cancer.

Okay, so you can take it.

You can take it.

Okay.

You only lose bone density after menopause.

You lose about 16 in perimenopause.

Oh, my gosh.

Just.

The good news keeps coming.

Menopause makes your feet grow.

Make sure.

What?

Feet grow?

Feet grow.

No, probably shrink a bit, actually, with bone loss and cartilage loss.

Ah, okay.

Night sweats only happen at night.

Well, if you call them night sweats, then they will.

But sweats can happen any time of the day.

Okay.

Hormones don't affect your gums or teeth.

No, they do.

They do.

So there is.

There's gum loss.

Yeah.

The teeth become weaker, all the things.

Great.

You can't get pregnant during perimenopause.

Okay.

So listen up, ladies.

Be protected.

Menopause starts at 50 for some women.

But a lot of women know it can be other ages.

Okay.

If your periods are regular, you're not in perimenopause.

Oh, okay.

You only need estrogen for hot flashes.

Both bioidentical hormones are always natural and safe.

So they are natural.

Usually you just have to be careful who makes them.

Really.

It's like anything, the hormones bit's fine, but it's how they're made and they're.

Formulation and they're formulated.

Weight gain in midlife is all about eating more and exercising less.

No, False.

Menopause means your sex life is over.

No, not at all.

It can actually get better.

Yeah, we should all be having if we want it.

You know, sex isn't a bad thing.

You know, look how easy it is to get Viagra.

Like for men, it's very accepting.

It's something that.

Yeah, we, we feel embarrassed talking about sex.

And we shouldn't, we shouldn't.

It's the age old double standard.

Menopause only lasts a few years.

If you're going to die a few years after your menopause, yes, but otherwise, no.

And testosterone is a male hormone and.

A female hormone, so that's true, but it's not exclusively.

And your body doesn't need hormones after menopause.

It's natural to age.

No, no, we have to.

We have to remember about natural and aging.

You know, there's lots of things that occur as we age, like raised blood pressure, but we don't watch someone's blood pressure get higher and higher.

Oh, my gosh.

Well, Dr.

Newson, this has been the most informative hour.

Thrilled to have had you on the iconic midlife.

No doubt our audience will just resonate so much with this episode.

So I thank you so much for your knowledge.

Oh, well, thanks for inviting me.

It's been a lot of fun.

Thank you.

Absolutely.

And can you tell the audience where they can find you?

Yeah, the easiest thing is just go to my website.

So it's Dr.

Drink louisenewson.co.uk, and then I've got all my resources and information there.

Thank you Dr.

Newson, for sharing your wisdom, your knowledge and your amazing expertise with us today on the Iconic Midlife.

And thank you to the audience for listening to the Iconic Midlife.

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